4N – Malnutrición en la Enfermedad Renal Crónica

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Course Overview

La malnutrición y la pérdida corporal progresiva de masa proteica y de reservas energéticas es una más de las complicaciones típicas asociadas a la enfermedad renal crónica (ERCA) y uno de los predictores independientes de mortalidad y morbilidad en estos pacientes.

Generalmente comienza en estadios iniciales de la ERC y se va agravando a medida que el filtrado glomerular desciende. Una vez empieza la diálisis, aproximadamente un tercio de los pacientes sufren desnutrición, incluso hasta el punto de que la muerte por caquexia no es rara, siendo esta desestimada en los registros de mortalidad. Las alteraciones nutricionales también van a condicionar los resultados del paciente trasplantado.

El origen de la desnutrición en pacientes con enfermedad renal crónica es multifactorial, y generalmente va asociado a inflamación e hipercatabolismo, conduciendo a una pérdida progresiva calórica y proteica, definida por la Sociedad Internacional de Metabolismo y Nutrición Renal como síndrome de desgaste proteico-energético o DPE (protein-energy wasting), concepto básico para poder explicar la etiopatogenia, las implicaciones clínicas, la importancia del diagnóstico y del tratamiento precoz y la influencia de las distintas técnicas dialíticas en el estado nutricional del paciente.

El manejo de la nutrición en la enfermedad renal crónica es complejo, pero es más sencillo y más fácil si se aborda de forma precoz, con el objetivo de prevenir y tratar. Lo ideal es que se realice de forma interdisciplinar, con equipos donde participen nefrólogos, enfermeras y auxiliares, nutricionistas, endocrinos y farmacéuticos, etc. La prevención, diagnóstico y tratamiento precoz de las alteraciones nutricionales en la ERC mejoran la morbimortalidad, disminuyen las hospitalizaciones, mejoran los resultados postrasplante y reducen los gastos asociados al paciente.

El presente curso tiene como objetivo conocer los mecanismos implicados en la malnutrición del paciente con enfermedad renal crónica, centrándonos en el concepto de síndrome de desgaste proteico-energético, valorar la importancia clínica, aprender la utilización rutinaria de la metodología diagnóstica y cómo realizar de forma práctica prevención y tratamiento.

113 thoughts on “4N – Malnutrición en la Enfermedad Renal Crónica”

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